What is your level of satisfaction with this product to treat your vaginal symptoms?

Very bad

Low

Average

Good

Excellent

Too early to say

Would taking a hormone therapy concern you?

YesNo

Why or why not?

Are you aware that healing the vaginal lining (restoring the cell lining by healing tears and damage) is an important aspect of treating vaginal dryness?

YesNo

Would having to talk to a pharmacist to get a product for this condition (because it is behind the pharmacy counter) versus just getting it off the front store shelf discourage you from trying a product?

Yes

A little

No

Why or why not?

If you were recommended RepaGyn, and not taking it, why not?

What is your level of satisfaction with RepaGyn?

Very bad

Low

Average

Good

Excellent

Not taking it / too early to say

How long did your doctor tell you that you will need to take RepaGyn for?

Until symptoms go away

A couple of months

6 months

1 year

For rest of your life

Did you have any problems obtaining RepaGyn?

No

Other

Anything else you would like to add regarding RepaGyn, the website, patient information, or other suggestions?

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Full Name

My mailing address is:

I consent to being contacted by BioSyent in the future to complete surveys or questionnaires

YesNo

My email address for future communication

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